Healthcare Provider Details

I. General information

NPI: 1659801694
Provider Name (Legal Business Name): LEIGH GRIFFIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N 12TH ST
RICHMOND VA
23298-5064
US

IV. Provider business mailing address

520 N 12TH ST
RICHMOND VA
23298-5064
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-1778
  • Fax: 804-828-6234
Mailing address:
  • Phone: 804-828-1778
  • Fax: 804-828-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDN123027
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number6761
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDN1859943
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number0401419781
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: